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Dayton VA director returns after stints in Phoenix, Cincinnati

Dayton VA director returns after stints in Phoenix, Cincinnati

Glenn Costie has learned to live in the hot seat at two of the most embattled VA medical centers in the nation.

First, he was brought in to lead the Dayton VA Medical Center in late 2011 in midst of a dental scandal at the health care facility.

The veteran VA leader was tapped temporarily to lead the embattled Phoenix VA for several months in 2014 amid allegations lengthy patient wait times for appointments led to veteran deaths at the Arizona medical center.

And this month, the 56-year-old Bellbrook resident completed a temporary assignment at the Cincinnati VA after whistle blower concerns over patient care, leading to the retirement of one senior VA regional leader and the reassignment of a high-ranking leader at the facility.

In Phoenix and Cincinnati, Costie said he brought more leaders into decision making, communicated those decisions directly to staff, and built relationships.

“At both medical centers, I found a lot of the resourcing decisions were made literally in the office of the director and then poorly communicated throughout the organization,” Costie said in an interview in his Dayton office.

“There were a lot of allegations about lack of resources and I kind of found it was really more a resource management issue,” he said. “That decisions weren’t being made in a timely manner and were not pushed down to the lowest level of the organization.

“Probably the other issue I worked on a lot was just relationship building,” he said. “We have a very effective culture here at Dayton called relationship-based care. It has three main tenets: taking care of veterans, taking care of our peers – the folks we work with – and take care of our self. If you do those three things very well, all your other metrics and quality indicators will rise.”

The Dayton Daily News left several messages for Cincinnati VA and Dayton VA union leaders for comment. Tinita Cole, president of American Federation of Government Employees Local 2209, which represents many Dayton VA workers, declined to comment on Costie when contacted.

The Dayton VA faced scheduling problems itself in at least one instance during Costie’s tenure. Dayton VA officials cited a “scheduling irregularity” in the pulmonary clinic that caused a backlog of more than 1,000 patient appointments at the clinic. An “informal list” was used to track patient appointments, including follow-up care, from at least October 2013 until May 2015, officials have said.

The informal list had roughly 150 patients who had died though those deaths were not linked to delayed care, Costie has said. The patients continued to receive medical care at the VA, but not at the clinic during the delays, officials have said.

Costie said he has pushed VA centers to focus on building relationships between leadership and staff, and between employees and patients.

“The relationship-based care culture really gets at the human interaction between employees and the veteran,” he said. “So it’s an employee-led culture. It’s not a top down directive from the bosses.”

The medical center director said “one simple thing” he does is reaching out directly to staff via email.

“I think that technique really breaks down barriers and really helps me connect with the staff,” he said.

The 32-year VA employee said he expects to retire from the Dayton VA, but he has not announced when he will leave the post.

Issues remain at VA centers in both Phoenix and Cincinnati, media reports show.

The Cincinnati VA was in the midst of a VA investigation over complaints about the influence of the University of Cincinnati Health Care System at the facility, the latest of continuing allegations about operations at the medical center. Costie said he expects the VA will take at least 90 days to release it’s findings.

Costie defended the facility, saying he found it “a high functioning organization providing very high quality care” that scored highly in an independent inspection.

The Phoenix VA has had frequent turnover in the top leadership post — seven leaders since it became the focus of a national headline making scandal over patient wait times and veteran deaths in 2014 — and four since Costie was temporarily in charge, according to the Arizona Republic newspaper.

U.S. Rep. Jeff Miller, chairman of the House Veterans Affairs Committee, criticized the Phoenix facility this month after a recently released VA Inspector General report showed “many of its original problems remain” and “the work environment in Phoenix is marred by confusion and dysfunction.”

VA officials have said the facility has increased staffing by hundreds of new employees and reduced wait times for appointments, media reports said.